HomeMy Public PortalAbout6239 CAMELLIA AVE_Building__ WORKERS'C WM,4SATJC1N DRIARATION
hereby affirm that I have a.certtflcate of conaerrt to .elf P FL I CAT IO N - O R�-B U r L Di N G E IT
_
Jnsure, or a certtficate-of.Workeri CornPerpatlorr IrsUranoe,
or a certified copy thereof (Sec 3800, Lab. C) r, COUNTY-Of LOS•ANGELES ; BUILDING'AND-'SAFETY
Policy No. Cwhpany r�
Certlfled copy)s b"by fumished. _ FOR APKICANT TO,FILL IN � N°
❑ Certified ropy b flied with the oounfy building Irmpec .
ILDiNG .
flon depdrtmertt AD RF3S
Datdy--��;AppllcdnT ZIP O �T,. -
V,13f- '{H2lHCATE OF<EXEMF30l � OF LOT
.( O
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section peed sibt'be Fotn lefid:lf the.permit li for oris T12AC1 BtoCSC LOT NOr B90K, PAGE
(This
'huodred'dollans.($100)or.lessw�' PARCH
LPE
I certify that In the.perforrribnce of-tho wbrk foc'whltK this. .•.
SPECIAL
permit*Ipued, I sfial(tiot employ artyPeribn,In 9ny-mahr»r. �a [(/�:: COtDfll
as to become suhle t to ihq Work". 'CBmplasc�ilon"Law#', O
Zf
fate -Applicant 4 ARCHITECT
NOTJCE TO It�PPLIC4Nf:,if;,after•mokIN•thls'Csrtlfi�� N
Of - � ENGI - NO• P TYPE, Fl BY o<
'Exemption, you should:becorpe sebled ri t� the W(x*eZ E-, C>
Com Ion ovfsloni of.t a Labor Code,
PerAW Pr h you•sriusi forth AEDi�ESS
_with comply wht such_proylsibrs;or_this,•Rermltshall 'be TEir� STATI.STICALCIASSJF)CADON API, , CONDO'. N
deemrevoked. �&_ _NO. R7 J. Y /y Z
ed
-i UCU4SED-C RACTORS.DECL RATf00,1 Y�cl ,,+ LIC Q_ASS Na 6Y/ a DWELL ttNITs i
t h�reby'offirrn that I am Ilteiaacl rider provWors.ctf Chopter 9 . `�• "O SFjkU MAP .94
(commencing with Sgd[bri 7000 6f.D1v1slo4r-3of the DpUness LK
an�Prof awl onrCgde;sad my. in full fgrcear4'effed'. b C]A55 y
SO. NO. OFNO. OF
utorse NuMer .' I Sul : STORrEs �- FAM ONE TOT .1331.&1 _
f = 1 7 �. `- VALUAUQN
# " � DESM PT10N OF WORK i VCMJ New ❑ ; GECK r 1331.94
_ /+ NE ❑ -
I atn exempt ► ( �[�
Ert]
BAP.Q•.,for',thl-i rgasorj t' I�/UR LCL ii /�yp pptt.
t ^I]rfiw, EXISTING BLDG. DEMOI•� 0000
J 71 d7�7d.
SigrKtt, - , ` ;; APPLIcANT(PRINT_ _ r t o. Rwu 7714. 1 • Ffi112: 4
' QWNER-BUILDER DEGLAR4TloN DATE
I hereby afffrrn that I am exempt frpm the Gontiacfo�s-LlcoriK. - - - -•
Low fdW`the following reaps.(,&�qtlon 7031',5;"mess and Abo
Professlons Codg):
'❑ I,-�s owner of-th6.prbperty, gr my employees.with BUILDING
wopgs,csq their sole c6mpbrisation,will do*A work and - -the structure It hatlntended or offerdd for.sple(S,soion.
-"p�islness.and Professions Co¢et) MtYVING• ._ TEL
ADDRESS-
I, as owner of the property,a(h exclusively contradlnp CONTRAL NO,
-With.IlcerLeed contractors to.construd the prole�t�s6c- ADDRESS _
tion 7041, Buslrien bred Qrofesstbt -r,o .)
OD1 STiZJC'TION LENDING A60.4CV YARD-. H%i
I'hereby a{ftmi that thgre Is a construction Igndl�p opency.,
the'pe4co once of thb work for which this pertnlY lq'issae�d •P-L
(Sec:-'3D07, Clv. C} SIDE.
z L Pa.;i
Lenders Ng1me
�r1L LDMAr Rif:
Letiders'Address +0 P.0 Fee Fermin F� -
I certify that-I have read this.appIkatian and state that the bsuante iDNA F/C i
above Information Is correct..l agree to comply.w4 all County Imr8st4pation :. r
ordingn.oes and Stdfe laws rolating id building 66rstru4tlon, Tonal Fee LDMA Perm.
and hereby autkorizdrep"%wntatives of this County-to enter.
upon the above-rnebtioryed pr6perty'for,lrsp6di4n purposes-
ie t m mv*a hon DaLAKAfo[r rL j+'r-!u
S gn&oe 94 Applkam or Agent Y
r
COUNTY OF LOS ANGELES TEMPLE CITY if 0508 %ILDRESIDERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUiAS E61` BL 0505 9608200054
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY G L-* r
PHONE: (818) 285-0488 EXT:LEGAL ID: NG. 0 NEW
T
TR: 50836 LT: 0006 SQ. FT STORIES TYPE OCCLP GROUP 6739 CAMELLIA AV
STRUCTURE: 2700 2 V R3 TEMP G
GARAGE; 809 2 NEAREST CROSS STREET:
ASSESSOR IN-RKMATION OTHER: TfMJMAS PAGE: GRID: LOCALITY: TEMPLE CITY _
USETENANT: • 10/01/Q6 TC .08/20/97
TEL. BLDGS. NOW ON -
VALUATION: FINAL 1)Afh
CAMELLIA HOMES L P .219,20.0 /'_11_q
2100 ORANGEWOOD FEES PAID
i7
ORANGE, G 9M8
NEW SINGLE FAMILY RESIDENCE
FEE DESCRIPTION: @I,IANTITY: UOM: RIOUITAPPLICANT: TEL. NO: :
ALEXANDER/CATANIA DEV., INC. (714) 937-0433- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESQ 19200.00 VAL 21.92 SPECIAL CONDITIONS'-
B2 PERMIT W/EMIR 1 00_r 0 VAL 289.05
�a 2,338.72
T2
CONTRACTOR: -TEL. . ` �' �~��
SIGNATURE
ALEXANDER/CATANIA DEVELOPMENT - LOCATION AND SETBACKS
2100 W. ORANGEWI= AV.STE 110 LIENO
ORANGE, G 92669 ✓J/ARCHITECT L. NO: FOUNDATION/TROMR
v
LIC. NO: / Hitt 11 .
L s•
LINDERFLOM INSULATION
MAP kO- SEWER KA BOOK:
153h269 lc 83- FM 3• 41 P U S U C VV IRI S IST LEVEL FLIDOR SHEATH
STAT
� . �;, -
1. r a
Ll
ROOF SHEATHING
AIR QUALITY: 1000 FEET MATERIALS \`�1l�_ `✓
FIRE DEPT.
NO NO NO `" DEPT.BLDG
����
REQUI-RED FROM EXI ST
SET BACK YARD: HWY: PROP LINE: WIDTH: r �
NEAR PANELS
FRONT PL- ��(j�
SIDE PL-
EXTERIOR
LOT DkAI
15M DETECTIONN DEVICES
FIRE DEPARTMENT APPROVAL
D�G
REPORT ID: DPR261 ROUTE TO: BS0508